People at high risk of overdose are dying in their own homes, but a new program aims to prevent that. Vancouver Coastal Health’s Substance use Treatment and Response Team or START provides rapid access to at-home detox for those who need help stopping or stabilizing their substance use. The goal of the START program is to provide the right services, at the right time, in the right place.
Research shows people are more likely to have successful outcomes with withdrawal and detox if they can go through the process in their own home with supports in place. “For those individuals who will not go into residential detox because of the stigma, this is far more palatable,” says Mary Marlow, Manager Mental Health and Substance Use, Vancouver Coastal Health. “It also works well for people trying to hold down a job, those with disabilities, and single mothers with children.”
To be eligible for the START program, individuals must meet certain criteria including: be 19 and older, live in Vancouver, and be in a safe, stable substance-free environment. Applicants must have a 24-hour support person to get through the withdrawal process. It takes up to two weeks from intake to completion, and involves assessment by a nurse and physician, followed by daily home visits for the first five days of the program.
Within two hours of receiving a referral, one of the START nurses will make contact with the client and arrange for an intake assessment. All opioid dependent clients receive take-home naloxone kits, and they, along with their support person, are trained on how to use the life-saving antidote.
The first week of the program is the medical care component. Medications such as Suboxone are used to help stabilize people over time. “The medical stabilization piece is the beginning of the journey; it provides a foundation for the deeper work to follow,” says Dr. John Álvarez de Lorenzana, Physician Lead, START.
The second week of the program involves connecting clients to resources within Vancouver Coastal Health to support their ongoing recovery plans.
The START program is expected to help more than 400 people per year.
Referrals can be made through community health centres, physicians with opioid dependent clients, and through existing VCH programs including:
Access Central: 1 (866) 658-1221
Central Addictions Intake Team: (604) 263-7377
Access and Assessment Centre: (604) 875-8289
START: email@example.com or (604) 675-2455
START is part of a larger strategy to create new spaces across the province to meet the need for more home and mobile withdrawal management services.
The program is also part of Vancouver Coastal Health’s response to the Provincial Public Health Emergency declared in April to address the unprecedented spike in drug overdose deaths, and supports the work of the newly formed Joint Task Force on Overdose Response.